Risk Management

Working to identify and reduce potential risk exposures in the medical practice is an ongoing process.

 

Advertising and Use of Patient Testimonials

• Texas Medical Board explains the rules on Physician Advertising Chapter 164. These include the prohibitions on Misleading or Deceptive Advertising 164.3 and the limitations on the use of patient testimonials, as does Advertising Records and Responsibility 164.5(c).
• The Medical Practice Act Code 164.052(6) includes as a prohibited practice false, deceptive or misleading advertising.
• Texas Medical Association (TMA) whitepaper Advertising Restrictions.
• AMA Code of Medical Ethics covers Professional Self-Regulation Opinion 9.6.1 Advertising & Publicity

 

Autonomy - in Clinical Decision Making and in a Financial-Business Setting 

 

Billing and Prompt Pay Discounts

 

Charity Care/Good Samaritan Law/Volunteer Protection Act

• TMA whitepaper - Texas Charitable Immunity Act
• TMA whitepaper - Limiting Liability for Providing Charity Health Care 
• TMA - Consent Form for Charity Care

 

Compassionate Use Act - CBD oil

The Texas Compassionate Use Act (2015 SB 339) requires the Department of Public Safety (DPS) to maintain a registry of physicians who treat epilepsy for the purpose of prescribing low-THC cannabis (CBD oil) to patients who have been diagnosed with intractable epilepsy. For more from DPS.

DPS also maintains a list of the licensed dispensing organizations that cultivate, process and dispense low-THC cannabis to a patient for whom it is prescribed.

The Medical Practice Act-Texas Occupations Code, Title 3 Health Professions, Subtitle B Physicians, in Chapter 169 Authority to Prescribe Low-THC Cannabis to Certain Patients for Compassionate Use explains who is authorized to prescribe and under what very limited circumstances.

Before a physician may prescribe or renew a prescription for low-THC cannabis for a patient, the physician must register as the prescriber for that patient in the compassionate-use registry defined in Texas Health & Safety Code, Title 6, Subtitle C, Chapter 487 Texas Compassionate-Use Act.

Texas Medicine, May 2018 issue: Oversold? Has cannabis oil been overhyped in Texas? 
TMA, June 29, 2018: FDA approves cannabidiol, but drug still faces hurdles

 

Conflicts of Interest - Self Referral and Physician Ownership

• AMA Code of Medical Ethics - Professional Self-Regulation - Opinion 9.6.9 Physician Self-Referral
• TMA Board of Councilors Opinion - Disclosure of Conflicts to Patients
• TMA articles on physician ownership.
• TMA publication Navigating the Referral Minefield: Stark and Antikickback Rules for CME credit. 
• TMLT The Reporter 2013 Volume 5, beginning of page 6 Stark: How to stay on the right side of the law.
• CMS - referring Medicare patients to an entity with which the physician/family has a financial relationship.
• CMS - reporting requirements re: physician ownership in hospitals MLN Matters SE1332 of Jan 6, 2014.
• CMS - disclosure of physician ownership in hospitals MLN Matters JA6306 of March 6, 2009.
• Texas Occupations Code/Medical Practice Act Sect 162.052 Notice of Certain Ownership Interests requires physicians who hold an ownership interest in certain specialized hospitals to submit a Notice of Ownership Interest in a Niche Hospital to the Texas Department of State Health Services, as well to to disclose the fact to the patient Sect 105.002.

 

Cybersecurity and Risk Assessments 

 

EMTALA

 

End of Life Care

 

HIPAA and Private Health Information (PHI)

 

Informed Consent

• TMA whitepaper - Informed Consent 
• TMA article - Informed Consent: A process of communication 
• TMA article - Conversation counts: Improving informed consent improves patient-centered care

 

Liability Protection

• TMA - Articles and guidance
• Professional liability insurers
• Out-of-state patients - Texas physicians may wish to have patients from out-of-state sign a consent agreement that would include "choice of law and forum" language that all health care rendered shall be governed exclusively and only by Texas law and that any legal action that relates to the care shall be brought only in a Texas court.
 —  See emergency care and non-emergency care for example consent form language.
 — Texas Medicine, June 2016 issue - Access Preserved - New Mexico law allows Texas physicians to avoid lawsuits across the border.

 

Patient-Physician Communications - emailing, deaf/hearing impaired, limited-English proficiency, interpreter and translator resources.

 

Patient-Physician Relations - guidance and procedures for terminating the relationship.

 

Physician Extenders - info and resources for supervision of physician assistants and nurse practitioners.

 

Prescription Monitoring Program (PMP) - Pain Management - RX Drug Abuse/Diversion  

 

Reporting Duties - guidance, reporting resources, and links to Texas statutes when a physician encounters situations involving child abuse/neglect, communicable diseases, impaired drivers, or threats of violence. 

 

Reputation Management - info and resources on preventing and repairing threats to your online reputation and building a strong positive online presence. 

 

Subpoenas

• TMA - How to Respond to a Subpoena
• TMA whitepaper - Subpoenas for Medical Records
• TMA whitepaper - Fees for Copies of Medical Records-copy fees and subpoenas 
• TMA - What to do when you're caught in the middle of a personal injury suit.

 

Texas Medical Association (TMA) - Risk Management Articles and Resources

 

Texas Medical Liability Trust (TMLT) - Risk Management Tools and Resources

Risk management help
• Practice Review 
• Privacy and Security Toolkits
• The Top 5 Things That Get Physicians Sued.